1 Project Summary/ Abstract
2 Children with speech sound disorders (SSD) produce speech sound errors beyond a developmentally-
3 appropriate age, make up a significant portion of school-based speech-language pathologist (SLP) caseloads.
4 Currently, we know that difficulties with speech production are often associated with other learning disabilities
5 (6-7), particularly reading (8-11) and spelling (12-13) disorders. Speech sound therapy is effective at
6 improving speech sound production (25) and has downstream effects on additional phonological
7 knowledge required for word decoding, speech perception, phonological working memory, and spelling (6-13).
8 There are features of the school-based speech sound therapy environment that are considered active
9 ingredients for change. For example, session dosage positively impacts speech sound accuracy (25); however,
10 group format has been largely neglected as a malleable feature of the therapy environment in clinical research
11 despite the ubiquitous provision of group therapy in schools (20). The dynamics between characteristics of the
12 speech sound therapy environment is currently unknown, but is a daily decision for school-based SLPs.
13 The overall objective of this exploratory, pre-implementation proposal is to study the active ingredients of
14 school-based speech sound therapy for children with SSDs. The project will investigate features of the speech
15 sound therapy environment (e.g., group format, dosage, session frequency/duration, therapy approach) as
16 they relate to individual differences in children’s speech sound production skills and their more generalized
17 phonological knowledge, required for successful word decoding and spelling. The central hypothesis to this
18 work is that features of the speech sound therapy environment proximally improve speech sound production,
19 and distally improve phonological knowledge. Therefore, speech sound therapy outcomes extend beyond “just
20 speech” (46) and into academic performance. Crucially, phonological knowledge varies for individual children.
21 This innovative investigation will comprehensively examine the dynamics between features of the speech
22 sound therapy environment and their effect on phonological learning from a large sample of school-based
23 SLPs (N = 80) working with kindergarten, first, and second grade children (N = 400) with SSDs, in four non-
24 overlapping cohorts.
25 The proposed project will provide necessary pre-implementation evidence to determine “what works for whom”
26 within a school-based setting. There is a crucial need to understand the nature of the associations between the
27 school-based therapy environment and each child’s individual phonological knowledge profile to: 1) determine
28 efficient pathways to improving speech sound production accuracy and 2) mitigate long-term difficulties on
29 academic performance for this heterogeneous clinical population. Understanding these malleable features is
30 crucial to determining how therapy may be individually tailored to optimize outcomes for children with SSDs.
